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NPI Code Detail

MEDICARE: MR. MARLON TAN MUNESES MD

MEDICARE: MR. MARLON TAN MUNESES MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician036096593IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
5080173568OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1069003OTHERHEALTH ALLIANE
2384581OTHERUNITED MEDICAL RESOURCES
35369708OTHERAETNA
4109744OTHERPERSONAL CARE
6384581OTHERHEALTHLINK
75827807OTHERILBLUE CROSS BLUE SHIELD
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
91832428OTHERUNITED HEALTHCARE

General Provider Information

NPI Number : 1265422067
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARLON TAN MUNESES MD
Provider Business Mailing Address
First Line : 101 E 9TH ST
Second Line :
City : PANA
State : IL
Zip : 62557-1716
Country : US
Telephone Number : 217-562-2544
Fax Number : 217-562-6288
Provider Business Practice Location Address
First Line : 101 E 9TH ST
Second Line :
City : PANA
State : IL
Zip : 62557-1716
Country : US
Telephone Number : 217-562-2544
Fax Number : 217-562-6288
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2005
Last Update Date : 02/26/2021

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Directions to “ MR. MARLON TAN MUNESES MD” Practice Location

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